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Purpose: To compare the recurrence rate of primary pterygium surgery after the adjuvant use of Beta radiation, Mitomycin C, and conjunctival autograft. Methods: 180 eyes of 180 patients were included in the study. All cases had primary pterygium excision following the use of adjuvant therapy of Beta radiation or Mitomycin C (0.02% for 5 minutes) or conjunctival autograft. The study was conducted at Fayoum University Hospital, Fayoum, Egypt, and Misr University Hospital. The patients were randomly divided into three groups, with each group comprising 60 patients. Group (A) included patients treated with Beta radiation following Pterygium excision, group (B) patients had primary pterygium excision with the application of 0.02% Mitomycin C for 5 minutes, and group (C) patients had conjunctival autograft to cover the bare area after pterygium excision. Patients were followed up for three years postoperatively. Results: group A had the highest recurrence rate (33.3%) followed by group B (13.3%), and finally group C presented a recurrence rate of 6.7%. Group B showed the highest rate of intra-ocular postoperative complications, while no intra-ocular complications were recorded in group C. Common complications in groups A and B were scleral melting, keratitis, and Dellen formation. Conclusion: Using conjunctival autograft after primary pterygium excision gives the best results regarding the rate of recurrence and postoperative complications. Meanwhile, B-radiation or Mitomycin C did not prove to be as good.

Introduction To evaluate the efficacy of pattern laser trabeculoplasty (PLT) as a treatment for lower intraocular pressure among patients with primary open-angle glaucoma. Methods Cohort case study has been used as the study design. A total of 85 patients with bilateral open-angle glaucoma underwent bilateral pattern laser trabeculoplasty (PLT) to reduce intraocular pressure (IOP). The initial and consequent intraocular pressure of all the patients was evaluated at 3 months and 6 months. IOP results were compared before treatment and after 3 and 6 months of receiving treatment, using the paired T-test. Results The average intraocular pressure in the right eye was decreased from the pre-treatment level at 22.1 mm hg (+/− 0.78) to 18.8 mm hg (+/− 0.83), after six months following the treatment. It represented a 14.9% reduction of average intraocular pressure, which is statistically significant with a P- value 0.036, using Paired T-Test. On the contrary, the average intraocular pressure in the left eye decreased from the pre-treatment level at 22.7 mm hg (+/− 0.62) to 19.2 mm hg (+/− 0.80), representing 15.4% reduction of the average intraocular pressure. Conclusion The results have shown that pattern laser trabeculoplasty is a potential useful tool in treating open angle glaucoma.

Background Adverse drug reactions (ADRs) represent a major health care problem. Objective To identify the most common ADRs, drugs implicated in ADRs, and to assess their causality, severity, preventability and risk factors predisposing to reported ADRs in Jordan. Setting Al-Karak teaching hospital, southern of Jordan. Method A cross sectional observational study was carried out for 11 months from January to November 2013. Suspected ADRs were recorded in ADRs report forms and analyzed for causality, severity, and preventability. Main outcome measure: Most common ADRs, drugs involved in these ADRs, causality, severity, and preventability of suspected ADRs. Results A total of 64 reports were received. Some patients suffered more than one ADR. The total number of ADRs identified was 108. Forty one drugs were involved in causing these ADRs. About 2/3 of adverse reactions (73.4 %) did not cause admission to the hospital, whereas 26.6 % of the ADRs resulted in admission. Majority of the ADRs were type A (62.5 %). Most of ADRs (92.2 %) were assessed as probable. Nearly, 65.6 % of ADRs were categorized as mild. Majority of ADRs were assessed as “not preventable” (75 %). The most common classes of drugs involved in ADRs were antibiotics, analgesics, vaccines and antiepileptics. The most commonly identified ADRs were abdominal pain, skin rash, shortness of breath, fever, upper gastrointestinal bleeding and vomiting. Risk factors contributed to ADRs were age and polypharmacy. Conclusion Jordanian healthcare providers should be aware of the importance of detecting and reporting ADRs, in order to prevent and reduce the incidence of ADRs. Awareness of risk factors predisposing to ADRs may help in identifying patients with higher risk and therefore reducing the risk of these ADRs and improving patient outcome.

Background/aims To review management choices and outcomes for congenital lacrimal (anlage duct) fistulae performed by a single ophthalmologist over a 10-year interval. Methods All cases of congenital lacrimal fistulae with minimum follow-up of 1 year, seen and managed by the senior author (PJD) from 2000 to 2010, were retrieved from electronic medical records. Recorded data included demographic features, associated abnormalities of the lacrimal outflow apparatus and type of surgical intervention and outcome. Results 15 cases of lacrimal fistulae were identified. 67% were males, and mean age of presentation was 5 years. All presented with tearing from the eye or fistulous opening. Two patients had Down syndrome (13%). Mean follow-up was 7.3 years. While two cases required excision combined with endonasal dacryocystorhinostomy (DCR) or intubation, 9 of 11 (82%) operated cases were successfully treated with simple excision alone. Spontaneous resolution of symptoms occurred in 27% following successful treatment of concurrent nasolacrimal duct obstruction with lacrimal sac massage; in two of these cases, the fistulae were probed and found to have sealed spontaneously. The most common site of the fistula was at the inferior medial canthal area and was connected to the lacrimal sac or common canaliculus in all cases. Conclusions Congenital lacrimal fistulae may be successfully treated with simple excision alone in most cases. Adjunctive DCR or intubation can be reserved for those identified to have lacrimal outflow tract abnormalities.

Purpose To assess the long-term role of bevacizumab (Avastin; Genentech Inc, South San Francisco, California, USA) in inflammatory ocular neovascularization. Design Retrospective multicenter consecutive case series of inflammatory ocular neovascularization. Methods settings: Multicenter institutional and private practices. study population: Patients with inflammatory ocular neovascularization in one or both eyes of varying etiologies who failed standard therapy. intervention: Intravitreal injection of bevacizumab. main outcome measures: Improvement of best-corrected visual acuity (BCVA) expressed as logarithm of minimal angle of resolution (logMAR), and decrease in central foveal thickness as measured by optical coherence tomography at 6, 12, 18, and 24 months of follow-up. Results Mean logMAR BCVA (central foveal thickness) following intravitreal bevacizumab was as follows: baseline, 0.65 (6/27 or 20/90) (338 μm; 99 eyes of 96 patients); 6 months, 0.42 (6/16 or 20/53) (239 μm; 2.0 injections; 81 eyes); 12 months, 0.39 (6/15 or 20/49) (241 μm; 2.3 injections; 95 eyes); 18 months, 0.40 (6/15 or 20/50) (261 μm; 3.0 injections; 46 eyes); and 24 months, 0.34 (6/13 or 20/44) (265 μm; 3.6 injections; 27 eyes). Paired comparisons revealed significant visual improvement at 6 months of 2.4 lines ( P = .000), at 12 months of 2.5 lines ( P = .000), at 18 months of 2.5 lines ( P = .001), and at 24 months of 2.2 lines ( P = .013). Paired comparisons revealed significant central foveal flattening at 6 months of 78 μm ( P = .000), at 12 months of 85 μm ( P = .000), at 18 months of 90 μm ( P = .003), and at 24 months of 77 μm ( P = .022). Three eyes developed submacular fibrosis and 1 eye submacular hemorrhage. Conclusion Intravitreal bevacizumab led in the long-term to significant mean visual improvement of ≥2.2 lines and significant foveal flattening in a wide variety of inflammatory ocular diseases without major complications.

Orbital complications due to ethmoiditis are rare in neonates. A case of orbital abscess due to acute ethmoiditis in a 28-day-old girl is presented. A Successful outcome was achieved following antimicrobial therapy alone; spontaneous drainage of the abscess occurred from the lower lid without the need for surgery. From this case report, we intend to emphasize on eyelid retraction as a sign of neonatal orbital abscess, and to review all the available literature of similar cases.

Impalement injuries to the head and neck are quite rare, commonly lethal, and vision threatening when involving the orbit. Here, a case of impalement injury involving a steel bar to the neck and left orbit with full visual recovery is presented. The bar was removed, leaving non-displaced fractures of the floor of the left orbit and ethmoid bone. The disinserted left medial rectus was resutured. The perforated upper eyelid was sutured. The patient ended with mild ptosis.